Intrabronchial Valves for Treatment of Alveolar-Pleural Fistula in a Patient With Pneumocystis jirovecii Pneumonia

Vicencio, Alfin G.; Tozzi, M; Thompson, Cecilia M.; Satchell, Margaret; Delbello, David; Ting, Andrew; Harkin, Timothy J.

doi:10.1097/lbr.0000000000000104

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…Furthermore, EBVs can be easily removed when the air leaks are resolved to allow adequate time for tissue healing (11). We summarized the published cases using EBVs for PAL(s) in Table 1 (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). Only three cases were of patients with AIDS, and our case was the only patient whose SP was secondary to PC.…”

Section: Discussion/conclusionmentioning

confidence: 99%

Endobronchial Valves for the Treatment of Bronchopleural Fistula and Pneumothorax Caused by Pulmonary Cryptococcosis in an AIDS Patient

et al. 2020

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Section: Discussion/conclusionmentioning

confidence: 99%

Endobronchial Valves for the Treatment of Bronchopleural Fistula and Pneumothorax Caused by Pulmonary Cryptococcosis in an AIDS Patient

et al. 2020

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“…Most patients suffered from post-operative PAL, suppurative lung disease or spontaneous pneumothorax [ 3 ]. To date, there exists only one report in the current literature about EBV treatment of PAL secondary to pneumocystis jirovecii pneumonia [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Successful long-term treatment of persistent pulmonary air leak in pneumocystis jirovecii pneumonia by unidirectional endobronchial valves

Bader

Faul

Raab

et al. 2018

Respiratory Medicine Case Reports

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Spontaneous pneumothorax is a rare complication of pneumocystis jirovecii pneumonia. We report a patient with pneumocystis jirovecii pneumonia and therapy-refractory, right-sided pneumothorax due to persistent air leak (PAL) despite prolonged chest tube placement and multiple pleurodesis attempts. Due to the patient's morbidity, we evaluated if the PAL can be sealed by unidirectional endobronchial valves (EBVs). After occlusion of the right upper lobe by a balloon catheter, the air leak flow-rate decreased from 800 ml/min to 250 ml/min. Zephyr EBVs (ZEBVs) were placed in the segmental right upper lobe bronchi and subsequently, a complete resolution of the pneumothorax was noted. During 30 months of follow-up, neither recurrence of pneumothorax nor any adverse events of EBV treatment were noted. We conclude that ZEBV placement might be an effective and well-tolerated treatment option for PAL secondary to pneumocystis jirovecii pneumonia with promising long-term results.

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“…This case series described a reduction in the need for significant ventilator support and high oxygen requirement in ICU patients with severe PALs. Additionally, Spiration IBVs have been used in APFs following pulmonary infections such as pneumocystis jiroveci (16). Based on the design of the Spiration IBV, which allow for proximal drainage of secretions, these valves could theoretically be used in suppurative pulmonary infections complicated with a PAL as well.…”

Section: Clinical Literature Supporting the Use Of Spiration Ibvs Formentioning

confidence: 99%

Bronchoscopic valves for prolonged air leak: current status and technique

Mahajan

Khandhar

2017

J. Thorac. Dis.

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Unidirectional airway valves are devices used for the treatment of persistent air leaks (PALs) secondary to alveolar-pleural fistulas (APF) or bronchopleural fistulas (BPFs). These valves were originally developed as a non-surgical alternative to lung volume reduction surgery (LVRS) for patients with chronic obstructive pulmonary disease (COPD). Randomized trials investigating the use of valves for bronchoscopic LVRS did not lead to the Federal Drug Administration (FDA) approval, but stemming from these studies a Humanitarian Device Exemption (HDE) was granted to Spiration intrabronchial valves (IBVs) for the treatment of PALs. These valves are being increasingly utilized due to the effectiveness of IBVSs in reducing PALs, thus shortening duration of hospitalizations and minimizing the risk of hospital associated complications. The literature supporting the use of unidirectional airway valves for the bronchoscopic treatment of PALs is grounded primarily in case reports. While the current body of literature available to justify the use of unidirectional valves is limited to case series, current multicenter, randomized trials should provide further guidance regarding patient selection and effectiveness.

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Intrabronchial Valves for Treatment of Alveolar-Pleural Fistula in a Patient With Pneumocystis jirovecii Pneumonia

Cited by 3 publications

References 19 publications

Endobronchial Valves for the Treatment of Bronchopleural Fistula and Pneumothorax Caused by Pulmonary Cryptococcosis in an AIDS Patient

Endobronchial Valves for the Treatment of Bronchopleural Fistula and Pneumothorax Caused by Pulmonary Cryptococcosis in an AIDS Patient

Successful long-term treatment of persistent pulmonary air leak in pneumocystis jirovecii pneumonia by unidirectional endobronchial valves

Bronchoscopic valves for prolonged air leak: current status and technique

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